Chlamydial Developmental Cycle And Intracellular Niche
CT is a highly evolved pathogen that has a reduced genome, first sequenced by Stephens and collaborators in 1998. Its chromosome consists of approximately one million base pairs and encodes for up to 600 proteins . Analysis of chlamydial genes reveals that this bacterium heavily depends on host cell for nutrition and replication, indicating a complex evolution for adaptation to an obligate intracellular lifestyle.
The infectious EBs enter the host cell in membrane-bound vesicles that travel toward the perinucleus and fuse to form a single vacuole termed the inclusion. Once inside this modified phagosome, EBs differentiate into metabolically active but non-infectious reticulate bodies that are the replicative bacterial forms. RBs asynchronously multiply by binary fission within the confines of the growing inclusion. After numerous rounds of replication, RBs re-differentiate back into infectious EBs to be ready for spreading to adjacent cells . The ability of CT to cycle between resting and replicating organisms accounts for a drawback in the eradication of this intracellular pathogen. Finally, the infectious bacteria are released by two independent mechanisms, the host cell lysis, or the extrusion of the inclusion . A scheme of chlamydial developmental life cycle is shown in Figure 1.
Does Mumps Cause Infertility In Males
Childhood diseases such as mumps or chicken pox normally run their course and end without significant long-term effects. However, when a boy or an adult man contracts mumps, it can affect the testes and cause a condition called orchitis.
The prevalence of orchitis in young adults and adults ranges from 20% to 30%. Only in a small percentage of mumps-induced orchitis, the male experiences a reduction in sperm production, probably linked to changes in male hormones during the earliest stages of orchitis.
Important Challenges: Prevention Diagnosis And Treatment Of Chlamydial Infections
The widespread incidence and prevalence of sexually transmitted infections, especially among young population, made them a priority public-health concern worldwide. Screening, control programmes, and education in sexual behavioral aspects and contraception are fundamental for the prevention of chlamydial infections and their long-term sequelae, mainly PID and tubal infertility.
Routine screening allows the identification of asymptomatic carriers of CT and contributes to the early detection of chlamydial infections. Appropriated diagnostic services are required to obtain reliable results. The most confident tests for the detection of CT involve nucleid acid amplification techniques that are not available in all laboratories, especially in third-world countries. Nucleic acid amplification tests are more sensitive than culture or antigen tests. Improvement in molecular diagnostics will lead to improvement in treatment and prevention of damage to reproductive tissues. It has been shown that screening is cost-effective even in low prevalence populations, due to the high costs of treatment of complications resulting from undiagnosed and untreated chlamydial infections . The implement of additional targeted screening of women at risk will contribute to reduce the CT-associated infertility.
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How To Help Partners Get Treatment
If you are not sure whether your sexual partner will seek treatment, ask your doctor for extra chlamydia medication . You can give it to them so they can be treated as soon as possible.
This is known as patient delivered partner therapy for chlamydia. Talk to your doctor to see if PDPT is right for you and your sexual partner.
Chlamydia Can Cause Infertility
In women, untreated infection can spread into the fallopian tubes and cause the tubes to become blocked at the very ends. This is known as hydrosalpinx. They can also develop scar tissue around the fallopian tubes that makes it more difficult for the tube to pick up the egg at the time of ovulation. The problems can lead to infertility and an increased risk for ectopic pregnancy.
Distal tubal obstruction can be detected by performing a hysterosalpingogram. Pelvic adhesions , however, can only be detected by undergoing a surgical procedure to look inside of the abdominal cavity. This is usually done using a technique called laparoscopy where a fiber optic telescope is inserted through the belly button under general anesthesia. Since laparoscopy is a much more invasive procedure, it is desirable to avoid it whenever possible.
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How Do People Get Chlamydia
Chlamydia is transmitted through sexual contact with the penis, vagina, mouth, or anus of an infected partner. Ejaculation does not have to occur for chlamydia to be transmitted or acquired. Chlamydia can also be spread perinatally from an untreated mother to her baby during childbirth, resulting in ophthalmia neonatorum or pneumonia in some exposed infants. In published prospective studies, chlamydial conjunctivitis has been identified in 18-44% and chlamydial pneumonia in 3-16% of infants born to women with untreated chlamydial cervical infection at the time of delivery.9-12 While rectal or genital chlamydial infection has been shown to persist one year or longer in infants infected at birth,13 the possibility of sexual abuse should be considered in prepubertal children beyond the neonatal period with vaginal, urethral, or rectal chlamydial infection.
People who have had chlamydia and have been treated may get infected again if they have sexual contact with a person infected with chlamydia.14
How Chlamydia Can Lead To Problems Getting Pregnant
Chlamydia is a sexually transmitted disease caused by the bacteria Chlamydia Trachomatis. With an estimated 141 million cases occurring worldwide in 2013 alone, this disease is one of the most common and prevalent in the world today. While long-term effects such as blindness and arthritis are potential dangers, it is also important to understand the relationship between chlamydia and infertility.
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Vaginal Microbiome And Other Potential Pathogens
N. gonorrhoeae, C. trachomatis, and M. genitalium may not be the only organisms capable of damaging the reproductive tract. Both Mycoplasma hominis and Ureaplasma urealyticum, two common species of genital mycoplasma, have been investigated as possible causative agents for infertility and pelvic inflammation. M. hominis is commonly found in the upper genital tract. The adverse influence of M. hominis on the female reproductive tract was identified in 1976 by MÃ¥rdh and colleagues, as they demonstrated with in vitro organ cultures the swelling of the ciliated tubal epithelial cells due to M. hominis infection . The organism has been isolated from the fallopian tubes of women with a history of infertility and laparoscopically-confirmed salpingitis, although recent data have not necessarily reproduced these findings .
How Can Stds Cause Infertility
If left untreated, chlamydia and gonorrhea can spread to the uterus or fallopian tubes and cause pelvic inflammatory disease , which can lead to inflammation, scarring, and blockage in your reproductive organs, such as your fallopian tubes. Tubal scarring can block the tubes preventing the eggs from travelling to the uterus. Women who have damage to their fallopian tubes are also at risk for ectopic pregnancy.
In vitro fertilization is an effective form of fertility treatment for women who have had damage to their fallopian tubes due to STDs. During IVF, sperm and egg are combined in the lab to allow for fertilization outside of the body with subsequent transfer of the embryo back into the uterus.
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What Are The Symptoms Of Chlamydia
Chlamydia is known as a silent infection because most infected people are asymptomatic and lack abnormal physical examination findings. Estimates of the proportion of chlamydia-infected people who develop symptoms vary by setting and study methodology two published studies that incorporated modeling techniques to address limitations of point prevalence surveys estimated that only about 10% of men and 5-30% of women with laboratory-confirmed chlamydial infection develop symptoms.21.22 The incubation period of chlamydia is poorly defined. However, given the relatively slow replication cycle of the organism, symptoms may not appear until several weeks after exposure in those persons who develop symptoms.
In women, the bacteria initially infect the cervix, where the infection may cause signs and symptoms of cervicitis , and sometimes the urethra, which may result in signs and symptoms of urethritis . Infection can spread from the cervix to the upper reproductive tract , causing pelvic inflammatory disease , which may be asymptomatic 23 or acute, with typical symptoms of abdominal and/or pelvic pain, along with signs of cervical motion tenderness, and uterine or adnexal tenderness on examination.
Men who are symptomatic typically have urethritis, with a mucoid or watery urethral discharge and dysuria. A minority of infected men develop epididymitis , presenting with unilateral testicular pain, tenderness, and swelling.24
What Std Causes Infertility In Females
Chlamydia and gonorrhea are the two sexually transmitted diseases that can cause infertility or make pregnancy difficult in females.
Along with potentially causing PID, untreated chlamydia can cause problems during pregnancy, this includes preterm labor, low birth weight, and the passing on of the infection to the newborn. Untreated gonorrhea can also be passed on to a newborn during pregnancy and has also been linked to premature birth and low birth weight.
See also:Chlamydia and Gonorrhea: How to Know the Difference
One of the most reliable ways to keep an eye on your sexual health is through regular sexual health screening. This can be done with your doctor or from home with an at-home lab test.
LetsGetCheckeds range of at-home Sexual Health Tests can detect some of the most common sexually transmitted infections. Online results will be available within 2-5 days and our dedicated clinical team will be available to answer any questions you may have throughout the process. Should you test positive, you will receive a call to discuss your results and your treatment options.
- You have had unprotected sex
- You are experiencing symptoms of a sexually transmitted infection
- You are entering into a new sexual relationship
- You have received a notification from a previous partner that they are infected
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Fertility Treatments After Chlamydia
IVI are world leaders in treating difficult cases of infertility, and we apply our expertise and knowledge to even the most extreme situations. Each patient is treated as an individual and approached with the care and sensitivity that is expected in this field. Many will be delighted to hear that untreated chlamydia does not necessarily mean that it is impossible for a couple to conceive. With a little assistance from one of our clinics, many patients are able to see their dream of having a family come true.
IVF is a popular choice for those suffering from the after-effects of chlamydia. For women who may have scarring on their fallopian tubes, the process is ideal. The egg is collected from the ovary, fertilised and then implanted straight into the uterus. This makes it possible to circumvent any issues that the patient may have with blocked fallopian tubes or with tubal ligation. It also rules out any chance of ectopic pregnancy. Male patients may find that the speed and mobility of their sperm has been affected by chlamydia. Where this is the case it may be beneficial to take the sperm directly from the testes, rather than collecting it via ejaculate. This means that the best quality sperm can be taken straight from the source and used to fertilise the egg, which is then implanted into the uterus.
Other Infertility Risk Factors
Notwithstanding the potential issues with the womb and the fallopian tubes, chlamydia and infertility share another relationship. The most common is how the disease manifests itself in men. A urethral infection can spread to the testicles. This may cause a condition known as epididymitis, if this is not treated promptly, sterility may occur. Still, additional variables that may affect female fertility can include age, the level of ones immune system and a history of previous sexually transmitted diseases.
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How Can Chlamydia Be Prevented
Latex male condoms, when used consistently and correctly, can reduce the risk of getting or giving chlamydia.53 The surest way to avoid chlamydia is to abstain from vaginal, anal, and oral sex, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.
Sexual Behavior And Other Host Factors
Sexual initiation at young age and a higher number of sexual partners are associated with increased risk of CT infection . In a similar manner, having sex without protection favors CT contagion. This sexual behavior is also associated with higher incidence of sexually transmitted pathogens such as Neisseria gonorrhoeae
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What Are The Symptoms Of Chlamydia In Women
The symptoms of Chlamydia in women are rarely noticeable. Professionals reveal that among a huge number of patients, only 30% females show symptoms related to this disease and rest all suffer from silent infection. In case if symptoms of the disease are present in the body then the person will notice them within 3 weeks right from their occurrence.
Some of the major symptoms associated with Chlamydia disease are:
Spotting Signs Of Pelvic Inflammatory Disease
Although pelvic inflammatory disease may not cause any symptoms specific to the condition, many women may notice mild symptoms. These can include:
- Pain during sex that is felt deep within the pelvis
- Pain around the pelvis and lower abdomen
- Pain during urination
- Bleeding after sex and between periods
- Heavy or painful periods
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Treatments To Achieve Pregnancy When You Have Chlamydia
Chlamydia can be easily treated and cured with antibiotics such as azithromycin and doxycycline.
Chlamydia infected patients should abstain from sexual intercourse until they and their sex partners have been treated. Otherwise, there is a high reinfection risk with serious complications to reproductive health. To ensure that therapy has been effective, a subsequent control is recommended.
If the patients reproductive organs are damaged , In-Vitro Fertilization is the recommended treatment to achieve pregnancy. The damage caused by Chlamydia trachomatis bacteria frequently alters gamete transport or blocks the path of the fertilized egg towards the uterus.
However, In-Vitro Fertilization allows our specialists to obtain the eggs directly from the patients ovaries. These eggs are fertilized under controlled laboratory conditions to generate embryos with a higher implantation potential which are then transferred back into the patients uterus.
Therefore, In-Vitro Fertilization makes the fallopian tubes no longer indispensable, offering greater pregnancy probabilities when compared to other available treatments.
It is important to treat existing chlamydia infections before beginning an In-Vitro Fertilization cycle, as this may have an adverse effect on the success rates of this procedure.
Blood Tests To Detect Tubal Damage From Chlamydia
The most common test to detect chlamydia infection in women involves taking a swab from the cervix during a speculum exam in the doctors office. The swab is tested for chlamydia DNA. The problem with this test is that it does not tell the physician how long the infection has been present, how severe the infection is and whether the woman with the infection has sustained tubal damage. The swab test can also miss an infection that has moved up into the uterus or tubes and is no longer in the cervix.
Blood tests can also be performed to detect the antibodies the body makes when exposed to the chlamydia bacteria. These blood test are fairly predictive for finding women with tubal damage during laparoscopy. A recent study found that the presence of the chlamydia antibody predicted the presence of tubal damage correctly 62% of the time. Conversely, the absence of the chlamydia antibody predicted the absence of tubal damage 90% of the time.
It is important to note that the presence of elevated levels of chlamydia antibody does not necessarily mean that a woman has an active chlamydia infection. It simply indicates that she was exposed to the bacteria. In fact, it is estimated that, if left untreated, about 45% of infected women without symptoms will clear the bacteria from their bodies. In women who clear an infection rapidly, the risk of tubal damage may be low. On the other hand, persistent exposure may result in chronic inflammation and may increase the risk of tubal damage.
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The Link Between Stis And Fertility How Chlamydia And Gonorrhea Affect Fertility
Some patients have questions about STIs and fertility. They want to know if sexually transmitted infections like chlamydia and gonorrhea can affect their fertility. When you visit a Las Vegas fertility doctor at The Fertility Center of Las Vegas , you will learn the answer is yes.
Chlamydia and gonorrhea are common and preventable causes of pelvic inflammatory disease and infertility. For example, untreated chlamydia will cause PID in about 10-15% of women, which can block the fallopian tubes and cause infertility. Gonorrhea can cause similar problems. However, women may not realize they have an infection because these STIs often do not cause symptoms in women.
How Long Does It Take Chlamydia To Turn Into Pid
Bleeding between periods. How long after infection do symptoms appear? PID symptoms can appear shortly after being diagnosed with an STD such as chlamydia or gonorrhea. It may take upwards of a year for most people to develop PID, but others can develop it earlier, depending on the severity of the infection.
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Possible Treatment For Chlamydia
As per medical professionals, Chlamydia can be easily treated with the help of antibiotic therapy. These antibiotics can be assigned for the 7-day course with a single dose per day. It is essential to stay away from sexual activity for these 7 days so that infection can be controlled with ease and your partner does not get infected with it.
The commonly known antibiotics for this chlamydia in women treatment are Doxycycline and Azithromycin but professionals may also recommend few other antibiotics for this treatment. In case if the lady affected with Chlamydia is pregnant that few other antibiotics can also be used as like ethyl succinate, erythromycin, and amoxicillin but pregnant ladies should not consume doxycycline. It is also essential to make your partner aware about the disease and bring him to the medical professional to undergo important tests.